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• W1980182743 abstract "In his Comment (Oct 18, p 1405) about the controversies in prosthetic surgery for knee osteoarthritis,1Cobb JP Patient safety after partial and total knee replacement.Lancet. 2014; 384: 1405-1407Summary Full Text Full Text PDF PubMed Scopus (14) Google Scholar Justin Cobb makes several statements regarding the utility and focus of joint registries in general and specific allegations regarding the probity of the National Joint Registry for England, Wales, and Northern Ireland (NJR). These comments need redress. Cobb states that the NJR is industry-funded and implies that there is collusion to restrict access to unicompartmental knee replacement. This statement is incorrect. The NJR is funded by the tax-payer and owned by the UK Government. From April, 2014, going forward, industry also made a financial contribution to the NJR in return for postmarket surveillance data. Cobb also states that Justin Hunt and colleagues2Hunt LP Ben-Shlomo Y Clark EM et al.on behalf of the National Joint Registry for England and Wales45-day mortality after 467 779 knee replacements for osteoarthritis from the National Joint Registry for England and Wales: an observational study.Lancet. 2014; 384: 1429-1436Summary Full Text Full Text PDF PubMed Scopus (140) Google Scholar stop short of commending unicompartmental knee replacement compared with total knee replacement “to avoid conflict with the stream of registry publications promoting unicompartmental knee replacement over total knee replacement”. This comment also seeks to question the probity of the NJR, suggesting larger scale collusion is occurring. This assertion is also incorrect. Unique among joint registers, the NJR allows independent researchers to use the NJR dataset. The two papers that form the substance of Cobb's argument2Hunt LP Ben-Shlomo Y Clark EM et al.on behalf of the National Joint Registry for England and Wales45-day mortality after 467 779 knee replacements for osteoarthritis from the National Joint Registry for England and Wales: an observational study.Lancet. 2014; 384: 1429-1436Summary Full Text Full Text PDF PubMed Scopus (140) Google Scholar, 3Liddle AD Judge A Pandit H Murray DW Adverse outcomes after total and unicompartmental knee replacement in 101 330 matched patients: a study of data from the National Joint Registry for England and Wales.Lancet. 2014; 384: 1437-1445Summary Full Text Full Text PDF PubMed Scopus (385) Google Scholar are exemplars of this process. Investigators of these studies, one of which was internal2Hunt LP Ben-Shlomo Y Clark EM et al.on behalf of the National Joint Registry for England and Wales45-day mortality after 467 779 knee replacements for osteoarthritis from the National Joint Registry for England and Wales: an observational study.Lancet. 2014; 384: 1429-1436Summary Full Text Full Text PDF PubMed Scopus (140) Google Scholar and the other independent,3Liddle AD Judge A Pandit H Murray DW Adverse outcomes after total and unicompartmental knee replacement in 101 330 matched patients: a study of data from the National Joint Registry for England and Wales.Lancet. 2014; 384: 1437-1445Summary Full Text Full Text PDF PubMed Scopus (385) Google Scholar both had access to the NJR dataset. They have contrasting arguments, but use different study designs and analysis methods. We were encouraged that The Lancet published both studies side by side2Hunt LP Ben-Shlomo Y Clark EM et al.on behalf of the National Joint Registry for England and Wales45-day mortality after 467 779 knee replacements for osteoarthritis from the National Joint Registry for England and Wales: an observational study.Lancet. 2014; 384: 1429-1436Summary Full Text Full Text PDF PubMed Scopus (140) Google Scholar, 3Liddle AD Judge A Pandit H Murray DW Adverse outcomes after total and unicompartmental knee replacement in 101 330 matched patients: a study of data from the National Joint Registry for England and Wales.Lancet. 2014; 384: 1437-1445Summary Full Text Full Text PDF PubMed Scopus (385) Google Scholar to stimulate the debate that Cobb suggests the NJR wishes to close down. MP is Medical Director of the NJR and JMW is chair of the research sub-committee of NJR. MP reports fees from Johnson and Johnson. Patient safety after partial and total knee replacementMore than 90 000 people in the UK had knee replacements in 2012, according to the National Joint Registry of England and Wales (NJR).1 The human cost of this expensive surgery is addressed in two articles in The Lancet2,3 that question conclusions from the NJR, with major consequences for patient safety and the knee replacement industry. Full-Text PDF Open Access" @default.
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• W1980182743 date "2014-12-01" @default.
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• W1980182743 title "Patient safety after partial and total knee replacement" @default.
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• W1980182743 doi "https://doi.org/10.1016/s0140-6736(14)62365-5" @default.
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